Glen Louis Dubois, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA004465 Issued in TX

Practice address

2502 Morgan Ave
Corpus Christi, TX 78405-1807

Phone

(361) 888-6782

Fax

(361) 882-3076

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205913720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 MORGAN AVE",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051807",
            "telephone_number": "361-888-6782",
            "fax_number": "361-882-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 MORGAN AVE",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051807",
            "telephone_number": "361-888-6782",
            "fax_number": "361-882-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "GLEN",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA004465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00069083",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Lillian Drummond
• Diane P Drysdale
• DSGS Transportation LLC
• Dsi Oso Bay, LLC
• Danny Lee Dubberly, MD
• Keith Eric Dubois, PH.D.
• Molly S Dubow, P.T.
• Dubuis Health System, Inc.
• John W Dudley, HEARING AID DEPT
• Aaron Duenes

• Medical Physician Assistant in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.